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ST JUDE MEDICAL CLINIC SC
NPI 1326186941
Family Medicine in Chicago, IL

Active since February 03, 2007CLIA 14D0970052 · Waiver
3943 W 31ST ST, CHICAGO, IL 60623(773) 523-8773(773) 523-9259 Get Directions Write a Review

NPPES record last updated: January 27, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 27, 2020, Jan 22, 2020, Jan 7, 2020 and 1 more (4 updates tracked since 2019).

About St Jude Medical Clinic Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST JUDE MEDICAL CLINIC SC (NPI 1326186941) is a healthcare organization registered as a family medicine in Chicago, Illinois and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through November 11, 2026 and lists Roma Shukla, Manager, as its authorized official.

NPPES Registry Identity

NPI1326186941
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameST JUDE MEDICAL CLINIC SC
Location Address3943 W 31ST STChicago, IL 60623-4936
Mailing Address3943 W 31st StChicago, IL 60623-4936 · (773) 523-8773 · Fax (773) 523-9259
Phone(773) 523-8773
Fax(773) 523-9259
Organization SubpartNo
Authorized OfficialRoma ShuklaManager · (773) 523-8773
Enumeration DateFebruary 3, 2007
Last NPPES UpdateJanuary 27, 20204 updates tracked since enumeration
✔ NPI 1326186941 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3943 W 31ST ST, Chicago, IL 60623
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0970052

St Jude Medical Clinic · Chicago, IL
Active · expires Nov 11, 2026
CLIA Number14D0970052
Laboratory TypePhysician Office
Certificate Effective DateNovember 12, 2024
Certificate Expiration DateNovember 11, 2026
Laboratory DirectorManish Shukla
Laboratory Phone(773) 523-8773
Laboratory LocationSt Jude Medical Clinic3943 W 31st Street, Chicago, IL 60623
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RAZIA SULTANA KHAN MD
Family Medicine
3943 W 31ST ST
CHICAGO, IL 60623
Cook County (773) 523-8773
MRS. JOANNA SZKWARLA PA-C
Physician Assistant (Medical)
3943 W 31ST ST
CHICAGO, IL 60623
Cook County (773) 523-8773
YUNJI YOON
Nurse Practitioner (Family)
3943 W 31ST ST
CHICAGO, IL 60623
Cook County (773) 523-8773
MR. MANISH M SHUKLA MD
Family Medicine
3943 W 31ST ST, ST JUDE MEDICAL CENTER
CHICAGO, IL 60623
Cook County (773) 523-8773
MOUNT SINAI COMMUNITY FOUNDATION
Obstetrics & Gynecology
3943 W 31ST ST
CHICAGO, IL 60623
Cook County (773) 523-8773
LEA FOY OS CAPILI
Nurse Practitioner (Family)
3943 W 31ST ST
CHICAGO, IL 60623
Cook County (773) 523-8773

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St Jude Medical Clinic Sc's NPI number?

The NPI number for St Jude Medical Clinic Sc is 1326186941. It was assigned to this organization in the NPPES registry on February 3, 2007.

Where is St Jude Medical Clinic Sc located?

St Jude Medical Clinic Sc is located at 3943 W 31st St, Chicago, IL 60623. The listed phone number is (773) 523-8773.

What is St Jude Medical Clinic Sc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does St Jude Medical Clinic Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0970052) is associated with this NPI, valid through November 11, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does St Jude Medical Clinic Sc accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list St Jude Medical Clinic Sc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for St Jude Medical Clinic Sc was last updated on January 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.